Prostate Cancer Screening Tissue Biopsy

If screening tests indicate the possibility of cancer cells, a prostate biopsy may be ordered. A prostate biopsy removes a small amount of tissue from the gland. A pathologist, who specializes in detecting cellular evidence of disease and cancer cells, examines the tissue sample.

Transrectal Prostate Biopsy and Ultrasound

Prostate tissue is usually gathered using a biopsy needle inserted through the rectum. The procedure can generally be performed without anesthetic. The urologist inserts a needle guide through the anus using ultrasound to position the guide. The needle is then inserted through the hollow guide, and a small sample of tissue is obtained. When the sample is gathered, a sharp pain will be felt.

Pattern Biopsies

If biopsy is recommended due to an elevated PSA test result, the exact location of possible cancer cells may be unknown. In this case, a pattern biopsy is performed, in which samples are taken from six or more evenly spaced locations.

If the sample cannot be gathered through the rectum, the needle may be inserted through the urethra, or inserted between the anus and the scrotum. In these cases, either local or general anesthetic is used. As with a transrectal biopsy, the urologist uses ultrasound to pinpoint the correct location.

Preparing for a Biopsy

Before the procedure, inform your doctor of any allergies you have (especially if you react to anesthetic), and any medication you are taking (both over the counter and prescription). If you have a bleeding disorder, or any other medical condition, let your doctor know before the procedure.

Should you require general anesthetic for the procedure, you will not be allowed to eat or drink for twelve hours before the biopsy.

Risk Factors

Risk factors are quite low. You may experience some bleeding from the rectum if a transrectal procedure is performed. This should only last two or three days. It isn’t uncommon for semen to be discolored for up to a month after the tissue sample is taken.

Call you doctor if you have continuous bleeding, a fever, or an increase in pain after the procedure.

Test Results

A pathologist will examine the tissue sample at the microscopic level, looking for evidence of cancer cells. The pathologist ranks the sample using the Gleason scoring system; the higher the score, the more advanced the cancer.

Lymph Node Biopsies

If cancer is detected, further tests may be required to determine if the cancer has metastasized, and spread to other organs. A lymph node biopsy may be ordered. Lymph node tissue samples can be gathered either through needle biopsy or by surgical removal of lymph nodes.

Resources

Klatt, E. C. (nd). Prostate pathology. Retrieved January 29, 2003, from medlib.med.utah.edu/WebPath/tutorial/prostate/prostate.html.

National Library of Health. (updated 2001). Lymph node biopsy. Retrieved January 24, 2003 from www.nlm.nih.gov/medlineplus/ency/article/003933.htm.

Spengler, R. (updated 2001). Prostate biopsy. Retrieved January 24, 2003 from yalenewhavenhealth.org/library/healthguide/MedicalTests/topic.asp ?hwid=hw5504.